Perry Gershon

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Drug Crisis is Not Receding: Hope is Good, Solutions Are Better

opioid epidemic

Some issues transcend politics, and one is the nation’s drug crisis. Recent reports trumpet “hope” in ending the national tragedy, which is reflected locally. Addiction takes 130 American lives daily. But is the trumpeted data really hopeful? 

Realists should take a second look and then redouble the federal commitment to more prevention, accessible treatment, anti-trafficking law enforcement, targeted border interdiction, and source country efforts. The problem is complex, and a hard look at data suggests we are not yet winning.

In May, one national headline announced: “Hope in the drug crisis: New data shows prescription opioid use fell at a historic rate last year.” That data is encouraging. But behind that step forward are a dozen steps back or sideways.  

Yes, on the numbers, use of prescription opioids fell at a record rate in 2018, down 17 percent a record decline. But from what? A record high level. Measured against what substitutions? Record high use of other drugs. Resulting in what changes within emergency rooms, morgues, addiction centers, and other indicia of use? Unclear. 

The celebration is a bit early. In the 1990s and 2000s, pain management promoters  as we all know pushed addictive pain relievers, which clearly contributed to rising prescription opioid addiction rates. Federal and state lawsuits against manufacturers, reduced prescribing by doctors, and public vigilance have reduced overall use of prescription opioids. 

But other waves causing national addiction, overdose, and drug-related emergency admission rates to rise have hardly receded. If anything, the substitution effect has led to elevated use, addiction, and losses tied to other drugs. 

Today, we have increased trafficking  and projected increases in foreign-source heroin, cocaine, fentanyl, methamphetamine, other synthetics, and high-purity marijuana. None of those increases are helping reduce overall addiction, drug-related emergency room admissions, or health care costs.

Quite the reverse: Nationally, the most recent Drug Enforcement Administration data reveal America is losing the battle to turn back foreign-source drugs, even as we struggle to keep up with treatment needs and return to effective prevention messages. 

Notably, the combination of illicit and prescribed opioids, higher cocaine and meth availability, and reduced public attention from national leaders has led to a “sharp increase in the death rate for overdoses by teens and young adults,” according to another 2019 study. 

To be clear, however prescription drug abuse falls, use of heroin and other illicit drugs remains a major national scourge. Illicit heroin distribution with fentanyl, cocaine, meth and other drugs directly affects public health and safety, as much or more than declining prescription drug abuse. 

Perhaps more concerning, younger Americans are the chief victims of our national inattention, indifference and too often ineffective policies. They are the ones facing elevated death rates and increased overdoses from high-purity illicit drugs. 

To be specific, “death rates from drug overdoses for people ages 15 to 24 rose by 19.75 percent from 2006 to 2015,” and overall availability of high-purity drugs has continued to rise from 2015 forward. 

This is not all about prescription drugs. The National Institutes of Drug Abuse reported in 2019: “Among the more than 70,200 drug overdose deaths estimated in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (other synthetic narcotics) with more than 28,400 overdose deaths,” and the 70,000 number is up from 20,000 two decades ago.  

So, as annual drug deaths continue to rise, real solutions are needed. Even as on-the-spot use of overdose reversing naloxone rises, long term treatment is needed and often missing. Unless otherwise admitted to effective treatment, those addicted will continue to require resuscitation until they overdose without recovering.

Other indicia of crisis are not retreating. Thus, the National Substance Abuse and Mental Health Services Administration last year recorded an increase in emergency help calls not a decrease. 

Where does this realism lead? Optimally, to solutions. Net-net, we should be able to do better than we are doing. How specifically? 

While various legislative ideas circulate, getting ahead of this national drug crisis helping individuals and families at their wit’s end, financially and emotionally should be a burden more fully borne at the federal level.

Needed is a national recommitment to the idea that public health and safety particularly of younger Americans comes first. Needed is the understanding that the drug crisis is materially contributing to higher hospital, long-term health, health insurance, public education and law enforcement costs. 

The solution is a return to what works: Effective prevention and treatment, including incentives, access and follow-up; targeted anti-trafficking law enforcement, not just at the border but through mail and package shipments; work with foreign countries, from Colombia and Mexico to China on halting the drug production in their worlds; and stronger leadership in both Congress and the Administration.

Some crises will not recede on their own. They continue to radiate outward, in spreading sadness, tragedy and costs, widening the gap between hoped-for and actual public health and safety. 

Hope is good, and data that back up new hope is valuable. But let’s be realists, and get this problem solved, not celebrate before we have.

Perry Gershon is a widely recognized business leader and national commentator on business, trade, policy and politics. A congressional candidate for New York’s first district, he holds a B.A. from Yale and an M.B.A. from the Univ. of California, Berkeley.

 

Tackling Noxious Pollution in Suffolk Should Be a Priority

Port Jefferson ferry passes a power plant on its way to Bridgeport, Connecticut.

The American Lung Association is out with their latest numbers and they are bad: Air pollution is high and not being addressed in many regions. Ours is one. We sometimes take the simple things for granted like clean air and safe drinking water.

Unfortunately, air and water pollution in Suffolk County are real and need to be fixed. For the sake of our kids, health and future, Congress and the Administration need to step up. Ultimately, tackling rising air and water pollution seems a faraway issue, but they sneak on us with profound effect.

Here are the arresting facts for Suffolk County. The American Lung Association annually assesses the state of America’s air. The ALA just gave us their lowest mark – again. Our county earned a “grade of F” for air quality – indicating a spike.

Under the category of ozone (the bad, ground-level sort, not stratospheric “hole” type), we suffered 29 so-called “orange days,” which is “unhealthy” for sensitive populations (e.g. young, old, confronting heart, respiratory, diabetes and related health issues). We suffered two “red” days, completely unhealthy for anyone who breathes!

In Suffolk County, at risk groups include the young, those over 65, those with pediatric and adult asthma, chronic obstructive pulmonary diseases (like progressive emphysema, chronic bronchitis, and other respiratory ailments causing short breath), various cancers (especially lung cancer), cardio-vascular disease and diabetes.

The question is, why are we letting this obvious health and safety issue go unsolved? Answer: National leaders are dragging their feet. Who pays? Average Americans. Individually we cannot solve the problem, but together we can. And this is the time to do so.

Among rising sources of air pollution, the Environmental Protection Agency cites cars, power plants, industrial boilers, refineries, and chemical plants. That is why federal standardization and reasonable regulation are necessary. Overdoing regulation is wrong; underdoing is just as wrong.

As an East Coast resident, one cannot fail to comment on the devastating impact 259 mid-western coal-fired plants have on quality of life. Pollution from these plants have literally destroyed the health of thousands of lakes, ponds, rivers, streams and estuaries on the East Coast and affected our health.

Experts are blunt: “Burning coal releases toxic mercury that rains down into rivers and streams …” and “mercury is a powerful neurotoxin that can damage the brain and nervous system …” Unfortunately, “currently, coal fired plants are the largest single source of unregulated mercury in the United States, emitting over 33 tons of toxic mercury each year.” Here again, is a way to help clean up the air.

Why is EPA not being held accountable? Not doing more? Not recognizing that jobs notwithstanding this is having a profoundly adverse effect? In fact, the EPA is going in the reverse direction. Lowering the standards and letting each state set its own target. Never mind the fact that pollution from one state easily travels to others. Instead of ignoring these arresting facts, we need to address them.

Nationally, politicians debate all sorts of climate issues, but what about addressing air and water pollution right here? Why aren’t our local Congressional representatives not voicing loud objections as the EPA relaxes Obama era standards? Maybe we are missing the trees for the forest? The EPA under any administration should be thinking harder about health of average Americans, how to prevent diseases and end the radiating effects of avoidable air and water pollution.

This simple but noxious problem in our lives is serious but fixable. The goal should be to get EPA to understand politics aside citizens deserve cleaner air and water. Perhaps putting former corporate lobbyists in leadership positions at EPA is part of the problem. How do we assure accountability, when those invested in the status quo are setting standards?

Answers do exist and should be pushed. Example: Based on the troubling ALA findings for Suffolk County, priority should be phasing out heavy oil and diesel- burning regional power plants, such as in Port Jefferson and Long Island City (and across the LI Sound in Bridgeport), to reduce local health risks. We should pivot to cleaning up air and water at our doorstep and doing so now.

Of course, we should also deploy wind and solar at scale around Long Island, look around corners beyond incentives for hybrid cars and charging stations, which really do not get enough attention. How about federal incentives for north-south public transportation, such as light rail or rapid transit bus? How about linking the middle of Long Island with the North and South Shore?

Why not think “out of the box,” about a multi-modal public transportation network, multiple smooth transfer points, less mobile pollution from congestion on routes 110, 111 and 112? Just ideas – but their time has come. Action counts, far more than “infrastructure weeks,” which sound good but fix nothing.

Air and water pollution are real. If we are not going to treat this as a solvable problem today, when will we? The American Lung Association report will not garner much attention, but for all of us who breathe and deserve cleaner air and water in Suffolk it should.

Perry Gershon is a widely recognized business leader and national commentator on business, trade, policy and politics.  A congressional candidate for New York’s first district, he holds a B.A. from Yale and an M.B.A. from the Univ. of California.

The Border Crisis: Seeing is Believing, But Workable Answers Exist

border wall
A small fence separates densely populated Tijuana, Mexico, right, from the United States in the Border Patrol’s San Diego Sector. Construction is underway to extend a secondary fence over the top of this hill and eventually to the Pacific Ocean.
You have read more about the border than you ever wanted to, have formed opinions based on reported facts. I was exactly where you are. That is why, after extensive reading, I decided to go down to the border myself, and talk with America’s law enforcement community. This is what I learned.
 
First, whether you are Republican or Democrat, America is in trouble at the border. The daily, monthly and annual numbers make the point convincingly, as does watching events at the border. We need a real, workable and enduring solution to the influx, ways to manage those detained awaiting return or review of asylum claims, and more consensus on both the enormity of the issue and ways to fix it.
 
Second, private conversations with Customs and Border Patrol (CBP) officials are highly informative and surprisingly consistent, given the variety of issues they deal with. They reduce to this. From Arizona’s border to points east and west, border crossing problems are growing, severe and need a political – not just an operational – solution.
 
While CBP can monitor and enforce within resource limits, those detained are soon turned over to ICE, and some to HHS. How to process mounting border crossers is not a CBP task, although they are quick to suggest a comprehensive and integrated solution is likely needed to this comprehensive and integrated problem.
 
The central issue is not just young migrants, but an upsurge in impoverished asylum seekers, followed by drug and human trafficking, and the changing demographics of those seeking entry. The past was defined by Mexican migrants seeking work and trying to avoid capture, while many today are Central Americans seeking asylum.
 
When you ask why the rise in drug and human trafficking, a consistent answer comes back.
The bottleneck at entry points is bad actors trying to surge together with good people who have become indebted to ruthless drug cartels and stoop to must in order to crossing crimes to survive.
 
This again points to a political solution, a need for concerted effort to understand the problem, adjust process, facilities, laws and regulations to match an immediate problem – which is swamping the system. Our laws are designed to address those trying to hide in America, not openly turning themselves in. We need to be able to address both issues, effectively.
 
The last big topic that CBP officials raised hits us hard – and in every state, county and municipality in America: Drugs. They made clear, the majority of what we confront on American streets comes from outside the country. The challenge is that most is smuggled through at ports of entry, hidden in trucks and other conveyances.
 
While deterrence between ports of entry matters, the big issue is at the ports. Since high volumes of illegal drugs cross into the US at ports of entry, we should focus more effort there. A more complete wall might marginally increase deterrence between ports through lowering daily crossers, but the system is not overrun by those jumping CBP barriers – as most are caught. It is being overrun – and overrun by drugs also – at the ports of entry.
 
So, what is the answer? The answer is layered, comprehensive and political. Direct observation of the border crisis, and we have one, gives me hope that we can get to a solution. Democrats and Republicans should start with this: The crisis is evolving, and any wall between ports of entry is only a minimal solution.
 
The need is for new laws and resources to more effectively deter those seeking asylum, as well as trafficking in persons and drugs, through our ports of entry, not such between them. We have to go to where the real problem is, and address is squarely there.
 
The need is for better detention, processing and interagency coordination between CBP, ICE, HHS, State and local authorities, so that the process is functional and can, in an accordion-like or scalable way, pulse and recoil as needs surge and ebb at official border crossings.
 
The last need is for serious and meaningful outreach to Mexico to help get a handle on the problem on their side of the border, help stem this human and drug flow into and through Mexico, since they too are facing an inordinate burden from Central American migrants – and the drug cartels play an outsized role on their side of the border.
 
The bottom line is this: Our border is in crisis. I saw this with my own eyes. The inflow continues to affect our national dialogue, America’s civic cohesion, costs tied to public health and safety, as well as education, housing and other social issues. The best way to tackle the border is head-on. Deterrence between ports of entry will not do this alone, we need a thoughtful, comprehensive and enduring political solution.
 
That is my take-away. And this – it should not be a partisan issue. To arrive at a workable solution, other factors need to be considered – because they also matter. Foreign aid may strike some as a give-away, but if we do not invest in seeding rule of law, institutional and economic stability in our own hemisphere – the problem will only get worse. Shifting climate data only reinforces this point.
 
Finally, like it or not, any comprehensive border solution should – not for political but legal reasons – address the DACA kids. Democrats and Republicans have weighed in on this issue. These young people, brought to our country as children, bear no more responsibility for where they ended up than you or I do for where our parents chose to bring us up. The law is not blind to equity – and should not be here. Resolution of their status should be integrated into the broad border solution. Not to do so would be a major omission. And of course, we must systematically reunify separated families; that is also a matter of decency and law.
 
So, that is what I saw at America’s besieged southern border. And that is the roadmap for getting us back to decency, sovereignty, and order. No time like the present to start.
 
Perry Gershon is a widely recognized business leader and national commentator on business, trade, policy and politics.  A congressional candidate for New York’s first district, he holds a B.A. from Yale and an M.B.A. from the Univ. of California.